Anemona Hartocollis

New York City’s first confirmed case of Ebola has raised complicated logistical issues of how to trace the possible contacts of an infected patient in a city of more than 8 million people with a sprawling mass transit system and a large population of workers who commute every day from surrounding suburbs and states.

As Congress struggles to rein in health care costs as part of its sweeping reform efforts, hospitals in New York City and other urban areas that provide some of the most expensive care are among the primary targets.

The fear of swine flu is being compounded by new worries, this time among primary care doctors who say that they are swamped by calls from patients seeking the new vaccine, and that they are ill-prepared to cope with the nationwide drive to immunize everyone, particularly children and chronically ill adults.